简介：STIscanaffectchildrenatthreedevelopmenralstages:duringinfancy,whenmother-neonatetransmissionandsexualabusemustbeconsidered.prepubertally,asaresultofsexualabuse.duringadolescence,whensexualaelivitymaybeeonsensualorabusive.

简介：ConductdisordersConductdisordersarecharacterizedbyrepetitiveantisocialbehaviourthatlastsforatleast6months.Inyoungchildren,theclinicalpictureisdominatedbymarkedlyoppositionalbehavioursuchasdefiance,hostilityanddisruptivenessthatisclearlyoutsidethenormalrange(so-called'oppositional-defiantdisorder').Inolderagegroups,behaviourssuchasstealing,

简介：Emotionalproblemsinchildrenandadolescentsmaybegroupedintodistinctsyndromes,thoughthereisoverlapbetweenthem.

简介：AbstractPediatric and adult spinal cord injuries (SCI) are distinct entities. Children and adolescents with SCI must suffer from lifelong disabilities, which is a heavy burden on patients, their families and the society. There are differences in Chinese and foreign literature reports on the incidence, injury mechanism and prognosis of SCI in children and adolescents. In addition to traumatic injuries such as car accidents and falls, the proportion of sports injuries is increasing. The most common sports injury is the backbend during dance practice. Compared with adults, children and adolescents are considered to have a greater potential for neurological improvement. The pathogenesis and treatment of pediatric SCI remains unclear. The mainstream view is that the mechanism of nerve damage in pediatric SCI include flexion, hyperextension, longitudinal distraction and ischemia. We also discuss the advantages and disadvantages of drugs such as methylprednisolone in the treatment of pediatric SCI and the indications and timing of surgery. In addition, the complications of pediatric SCI are also worthy of attention. New imaging techniques such as diffusion tensor imaging and diffusion tensor tractography may be used for diagnosis and assessment of prognosis. This article reviews the epidemiology, pathogenesis, imaging, clinical characteristics, treatment and complications of SCI in children and adolescents. Although current treatment cannot completely restore neurological function, patient quality of life can be enhanced. Continued developments and advances in the research of SCI may eventually provide a cure for children and adolescents with this kind of injury.

简介：Children(5-12years)andadolescents(13-19years)withDownsyndrome(DS)possessasetofhealth,anatomical,physiological,cognitive,andpsycho-socialattributespredisposingthemtolimitationsontheirphysicalfitnessandphysicalactivity(PA)capacities.Thepaucityofstudiesandtheirconflictingfindingspreventaclearunderstandingand/orsubstantiationoftheselimitations.Thepurposeofthisarticlewastoreviewthemeasurement,determinantsandpromotionofphysicalfitnessandPAforyouth(i.e.,childrenandadolescents)withDS.TheexistingbodyofresearchindicatesthatyouthwithDS:1)havelowcardiovascularandmuscularfitness/exercisecapacity;2)demonstrateagreaterprevalenceofoverweightandobesity;3)alargeproportiondonotmeettherecommendedamountofdailyaerobicactivity;and4)theirPAlikelydeclinesthroughchildhoodandintoadolescence.Futureresearchshouldfocuson:1)strengthtestingandtrainingprotocols;2)methodologiestodeterminePAlevels;and3)practicalinterventionstoincreasePA.

简介：AbstractBackground:The standard treatment for pediatric differentiated thyroid carcinoma (DTC) still requires consideration because of a lack of clinical evidence. The purpose of this study was to summarize the clinical experiences and explore the risk factors for post-operative recurrence through a retrospective analysis to develop better clinical strategies for pediatric DTC.Methods:This study retrospectively analyzed children and adolescents with DTC who were treated between January 1999 and December 2014 at the Cancer Hospital, Chinese Academy of Medical Sciences. Clinicopathological results and outcomes were collected. A log-rank test of Kaplan-Meier curves and the Cox regression model were used to determine the factors associated with recurrence.Results:Data of 150 patients were collected in this study. During the follow-up, there was only one disease-related death. The recurrence rates at 3, 5, and 10 years were 13.6%, 18.7%, and 28.6%, respectively. There was a significant difference in the rate of recurrence according to age (P < 0.001), extrathyroidal extension (P < 0.001), lymph node metastasis (P = 0.023), and invasion of the trachea and esophageal wall (P = 0.004). Cox regression analysis demonstrated that age (P = 0.006) and extrathyroidal extension (P = 0.013) were significant dependent factors of post-operative recurrence.Conclusions:The prognosis of DTC in children and adolescents is favorable. A close follow-up is recommended because of the high recurrence rate. A comparatively higher recurrence rate was observed in the younger age group, and new age-based divisions may be needed to conveniently evaluate the possibility of recurrence.

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简介：AbstractImportance:Vitamin A (or retinol) has considerable antioxidative and anti-inflammatory attributes and it may have protective effects on the respiratory health of patients with cystic fibrosis (CF). This issue, however, remains controversial.Objective:The purpose of the present study was to investigate the relationship between serum retinol levels (SRL) and force expiratory volume in 1 second (FEV1) in patients with CF.Methods:All patients with pancreatic insufficiency attending the CF Department of "Agia Sofia" Children’s Hospital in Athens, Greece, aged 6 to 19 years during the 2012-2016 period, who could perform spirometry effectively, were included in the study. The impact of SRL on FEV1 was examined longitudinally and analyzed with generalized estimating equations.Results:The study included 231 patients and 851 SRL measurements were performed. In 25 (3.2%) cases the SRL were below the 5th percentile of reference distribution; none was above the 95th percentile. The analysis showed that SRL was positively correlated with the FEV1 (P < 0.001).Interpretation:In this sample of children and adolescents with CF, vitamin A deficiency was rare. Our results suggest a positive relationship between SRL and FEV1.

简介：1.IntroductionForanyonepayingattention,thisisadisruptivetimeinscienceingeneralandinhealthpromotionscienceinparticular.Obesityisthemostprevalentnutrition-relatedhealthproblemaroundtheglobe.Theissueofwhether,asiscommonlythought,obesityiscausativeofearlymortalityorwhetheritisonlyamarkerofriskhasbeenraised.Thelackofsubstantialandmaintainedchangeinchildobesitypreventionhasbeenrecognized,andnumerouslimitationsinourconceptualandmethodologicalapproachtoobesitypreventionhavebeenidentified.

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简介：AbstractImportance:As the most common subtype of pediatric rhabdomyosarcoma (RMS), the prognosis of embryonal RMS has rarely been investigated solely.Objective:To perform a population-based study to characterize the prognosis of embryonal RMS in children and adolescents.Methods:Demographic and clinical features were retrospectively evaluated in selected patients with embryonal RMS registered in the Surveillance, Epidemiology, and End Results (SEER) program from 1988 to 2016. Survival curves were compared using the log-rank test. A multivariate Cox proportional hazards model was developed to assess the impact of each factor on the overall survival. A nomogram was constructed based on the results of Cox regression model.Results:A total of 464 patients were included in the analysis, among which 64.6% were male and 70.2% were white patients. About 38.6% and 26.3% of the patients were at 1-4 years and 5-9 years, respectively. Cox analysis showed that patients at age group 5-9 years had the lowest risk of mortality (hazard ratio [HR], 0.277; 95% confidential interval [CI], 0.123-0.620), compared with patients diagnosed at less than 1-year-old, and age group 1-4 years had the second-best prognosis. Patients having distant tumors had significantly higher mortality risk (HR, 4.842; 95% CI, 2.804-8.362) than the patients with localized tumor. Compared with receiving no surgery or radiotherapy, receiving any combination of surgery and radiotherapy would lower the risk of mortality significantly (for surgery without radiotherapy: HR, 0.418; for radiotherapy without surgery: HR, 0.405; and for surgery plus radiotherapy: HR, 0.410).Interpretation:Age, stage at diagnosis, and treatment received were found to be the most important predictors of the overall survival of pediatric embryonal RMS.

简介：Background:Neighborhoodbuiltenvironmentmayprofoundlyinfluencechildren’sphysicalactivity(PA)andbodyweight.ThisstudysystematicallyreviewedscientificevidenceregardingtheimpactofbuiltenvironmentonPAandobesityamongchildrenandadolescentsinChina.Methods:AkeywordandreferencesearchwasconductedinActiveLivingResearch,CochraneLibrary,PubMed,andWebofScience.Studiesthatmetallofthefollowingcriteriawereincludedinthereview:(1)studydesigns-experimentalstudies,observationalstudies,andqualitativestudies;(2)studysubjects-Chinesechildrenand/oradolescentsaged≤17years;(3)exposures-neighborhoodbuiltenvironment;(4)outcomes-PAand/orbodyweightstatus;(5)articletype-peer-reviewedpublications;(6)timewindowofsearch-fromtheinceptionofanelectronicbibliographicdatabasetoMay31,2018;(7)country-China;and(8)language-articleswritteninEnglish.Results:Atotalof20studies,including16cross-sectionalstudies,3longitudinalstudies,and1descriptivestudy,metthepredeterminedselectioncriteriaandwereincludedinthereview.Atotalof13studiesadoptedsubjectivebuiltenvironmentmeasuresreportedbyparentsand/orchildren,2adoptedobjectivemeasures(e.g.,geographicalinformationsystem,fieldobservations),and5adoptedbothobjectiveandsubjectivemeasures.PAbehaviorsincludedPA,physicalinactivity,sedentarybehavior,active/passivecommutingfrom/toschool,andparkvisits.Amongthe16studiesthatprovidedsomequantitativeestimatesoftheinfluenceofbuiltenvironmentonPAandbodyweightstatus,allreportedastatisticallysignificantrelationshipintheexpecteddirection.Availabilityandaccessibilityinproximitytogreenspaces,parks,recreationalfacilities,andsidewalkswerefoundtobeassociatedwithincreasedPAlevels,reducedsedentarybehaviors,and/oractivecommutingamongChinesechildrenandadolescents.Incontrast,theabsenceofbikelanesandlivinginhigherdensityresidentialareaswer

简介：AbstractBackground:Postural tachycardia syndrome (POTS) is a common childhood disease that seriously affects the patient’s physical and mental health. This study aimed to investigate whether pre-treatment baseline left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) values were associated with symptom improvement after metoprolol therapy for children and adolescents with POTS.Methods:This retrospective study evaluated 51 children and adolescents with POTS who received metoprolol therapy at the Peking University First Hospital between November 2010 and July 2019. All patients had completed a standing test or basic head-up tilt test and cardiac echocardiography before treatment. Treatment response was evaluated 3 months after starting metoprolol therapy. The pre-treatment baseline LVEF and LVFS values were evaluated for correlations with decreases in the symptom score after treatment (ΔSS). Multivariable analysis was performed using factors with a P value of <0.100 in the univariate analyses and the demographic characteristics.Results:A comparison of responders and non-responders revealed no significant differences in demographic, hemodynamic characteristics, and urine specific gravity (all P > 0.050). However, responders had significantly higher baseline LVEF (71.09% ± 4.44% vs. 67.17% ± 4.88%, t = -2.789, P = 0.008) and LVFS values (40.00 [38.00, 42.00]% vs. 36.79% ± 4.11%, Z = -2.542, P = 0.010) than the non-responders. The baseline LVEF and LVFS were positively correlated with ΔSS (r = 0.378, P = 0.006; r = 0.363, P = 0.009), respectively. Logistic regression analysis revealed that LVEF was independently associated with the response to metoprolol therapy in children and adolescents with POTS (odds ratio: 1.201, 95% confidence interval: 1.039-1.387, P = 0.013).Conclusions:Pre-treatment baseline LVEF was associated with symptom improvement after metoprolol treatment for children and adolescents with POTS.

简介：AbstractBackground:Non-transport unintentional injuries (NTUIs) are major public concerns, especially among children and adolescents in low- and middle-income countries. With environmental and cognitive changes, a recent systematic description of global trends and regional differences concerning NTUIs is urgently needed for the global agenda of relevant policy-making and intervention target findings.Methods:We used mortality, population, and socio-demographic-index (SDI) data from Global Burden of Disease 2019 to analyze the trends of NTUIs mortality. We applied the slope index of inequality (SII) and relative index of inequality (RII) to measure the absolute and relative inequality between countries and territories. The concentration curve and concentration index (CI) were also used to measure the inequality. We conducted a sensitivity analysis to make our findings credible.Results:In 2019, there were 205,000 deaths due to NTUIs among children and adolescents aged 5 to 24 years, which decreased from 375,000 in 1990. In 2019, the age-standardized mortality rate (ASMR) was 8.13 per 100,000, ranging from the lowest in the Netherlands (0.90 per 100,000) to the highest in the Solomon Islands (29.34 per 100,000). The low-middle SDI group had the highest ASMR of NTUIs, while the low SDI group had the slowest decrease. After excluding the death caused by "exposure to forces of nature" and "other unintentional injuries" , drowning accounted for the most deaths in almost every SDI group, gender, and age group, but the major causes of death varied in different subgroups. For example, animal contact was a major cause in low and low-middle SDI groups but less in high SDI groups, while high and high-middle SDI groups had a higher proportion of deaths for foreign body and poisonings. The SII showed a declining trend, but the RII and CI did not, which might indicate that inequality was persistent. Similar results were found in the sensitivity analysis.Conclusions:Despite the declining trend of the mortality rate and the narrowing gap between countries, there were still a large number of children and adolescents dying from NTUIs, and those experiencing social-economic disadvantages remained at high mortality. Embedding the prevention of NTUIs into sustainable development goals might contribute to the progress of reducing death and inequalities, which ensures that no one is left behind.

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简介：此栏目所刊登的文章均为地道的原汁英语，适合高二学生阅读，也可作为老师们出题的参考材料，每期题裁各异，以便老师们灵活使用。

简介：此栏目所刊登的文章均为地道的原汁英语，可作为期中、期末考试及高考命题的素材，每期题裁各异，请同学们认真阅读。

简介：Laws(法律)forchildrenaregoodthings.Onehundredyearsagoinsomecountries,childrenworkedeighteenhoursadayinafactory1ageseven.Thefactoryownercouldbeatachild2fell